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Hypoglossal Nerve

Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Jungmin Seo, Jee Hye Wee, Jeong Hoan Park, Pona Park, Jeong-Whun Kim, Sung June Kim
OBJECTIVE: A novel nerve cuff electrode with embedded magnets was fabricated and developed. In this study, a pair of magnets was fully embedded and encapsulated in a liquid crystal polymer (LCP) substrate to utilize magnetic force in order to replace the conventional installing techniques of cuff electrodes. In vitro and in vivo experiments were conducted to evaluate the feasibility of the magnet-embedded nerve cuff electrode (MENCE). Lastly, several issues pertaining to the MENCE such as the cuff-to-nerve diameter ratio, the force of the magnets, and possible concerns were discussed in the discussion section...
October 20, 2016: Journal of Neural Engineering
F Pilolli, L Giordano, A Galli, M Bussi
The purpose of the present study was to evaluate the advantages of a video-assisted, minimally invasive transcervical approach to benign and malignant parapharyngeal space (PPS) tumours. Ten patients affected by benign and malignant PPS neoplasms underwent a combined transcervical and video-assisted minimally invasive approach, using Hopkins telescopes. We describe the operative technique and perform a review of the literature. Definitive histology revealed 3 pleomorphic adenomas, 2 schwannomas, 2 metastatic papillary thyroid carcinomas, one carcinoma ex pleomorphic adenoma, one cavernous haemangioma and one basal cell adenoma...
August 2016: Acta Otorhinolaryngologica Italica
Diane C Lim, Allan I Pack
Obstructive sleep apnea (OSA) is a worldwide disease whose prevalence is increasing as obesity rates increase. The link between obesity and OSA is likely to be the deposition of fat in the tongue, compromising upper airway size. The role of obesity varies in different ethnic groups, with Chinese being particularly sensitive to increases in weight. OSA lends itself to a personalized approach to diagnosis and therapy. For example, different clinical OSA subtypes likely benefit from therapy in different ways. Hypoglossal nerve stimulation is a useful second-line therapy in patients who cannot tolerate continous positive airway pressure (CPAP) machines or intraoral devices...
October 5, 2016: Annual Review of Medicine
Katherine Koral Green, B Tucker Woodson
Traditional upper airway surgery directly modifies skeletal and soft tissue structures surrounding the airway to treat obstructive sleep apnea (OSA). Upper airway stimulation (UAS) attempts to treat upper airway obstruction and OSA by stimulating the hypoglossal nerve. The Inspire II implant has been approved for clinical UAS. Basic science data support that UAS prevents obstruction and improves airflow. Clinical results demonstrate that UAS improves respiratory sleep metrics and improves both objective and subjective self-reported sleep and quality-of-life outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
Lachlan J McDowell, Marlene C Jacobson, Wilfred Levin
BACKGROUND: Hypoglossal nerve palsies are infrequent complications of head and neck radiotherapy. Treatments focus on maintaining function and prevention of abnormal airway-related swallowing events. METHODS: A patient with longstanding cranial neuropathies, including bilateral hypoglossal involvement, secondary to chemoradiotherapy for nasopharyngeal carcinoma, experienced repeated episodes of life-threatening complications. Initially, 2 courses of 2 weekly 24-hour intravenous methylprednisolone (IVMP) infusions were administered 2 years apart...
October 5, 2016: Head & Neck
C Heiser, B Hofauer
Obstructive sleep apnea (OSA) is a common disease in western industrialized countries with increasing prevalence. Gold standard of therapy is nocturnal positive pressure ventilation by continuous positive airway pressure (CPAP). Due to complications and side effects of ventilation, therapy adherence is limited. Recently an alternative surgical treatment has become available for these patients, which uses established techniques to stimulate the hypoglossus nerve to open the upper airway during sleep. The aim of this work is to provide an overview of the history and current state of scientific knowledge of this therapy in the treatment of OSA...
September 29, 2016: HNO
Ji Hyuk Han, Mischelle J Suh, Jin Won Kim, Hyun Sang Cho, In Seok Moon
CONCLUSION: In this series, the split type hypoglossal-facial nerve anastomosis resulted in more favorable outcomes in terms of both facial function and tongue atrophy. OBJECTIVE: This study compared surgical techniques for hypoglossal-facial nerve anastomosis after schwannoma removal and evaluated which technique achieves better facial outcomes and less tongue morbidity. METHOD: This study included 14 patients who underwent hypoglossal-facial nerve anastomosis after schwannoma removal and were followed for more than 1 year...
August 12, 2016: Acta Oto-laryngologica
Barbara Buffoli, Marco Ferrari, Francesco Belotti, Davide Lancini, Marco Angelo Cocchi, Mauro Labanca, Manfred Tschabitscher, Rita Rezzani, Luigi Fabrizio Rodella
Additional extrinsic muscles of the tongue are reported in literature and one of them is the myloglossus muscle (MGM). Since MGM is nowadays considered as anatomical variant, the aim of this study is to clarify some open questions by evaluating and describing the myloglossal anatomy (including both MGM and its ligamentous counterpart) during human cadaver dissections. Twenty-one regions (including masticator space, sublingual space and adjacent areas) were dissected and the presence and appearance of myloglossus were considered, together with its proximal and distal insertions, vascularisation and innervation...
September 26, 2016: Folia Morphologica (Warsz)
Takafumi Hosokawa, Hideto Nakajima, Akihiro Tsukahara, Kiich Unoda, Shimon Ishida, Fumiharu Kimura
A 64-year-old woman developed acute paralysis of glossopharyngeal, vagus, accessory, and hypoglossal nerves on the left side after pain in the head and the left ear and throat. Cerebrospinal fluid examination revealed lymphocytic pleocytosis and elevated protein concentration. Varicella-zoster virus (VZV)-DNA was detected by PCR from cerebrospinal fluid. The diagnosis of lower cranial polyneuropathy due to VZV reactivation was made. After oral administration of an anti-viral agent and steroid, all symptoms and signs dramatically improved...
September 16, 2016: Rinshō Shinkeigaku, Clinical Neurology
David J Noble, Daniel Scoffings, Thankamma Ajithkumar, Michael V Williams, Sarah J Jefferies
OBJECTIVE: There is no consensus approach to covering skull base meningeal reflections-and cerebrospinal fluid (CSF) therein-of the posterior fossa cranial nerves (CNs VII-XII) when planning radiotherapy (RT) for medulloblastoma and ependymoma. We sought to determine whether MRI and specifically fast imaging employing steady-state acquisition (FIESTA) sequences can answer this anatomical question and guide RT planning. METHODS: 96 posterior fossa FIESTA sequences were reviewed...
September 29, 2016: British Journal of Radiology
Ryan J Soose, M Boyd Gillespie
OBJECTIVES: Review the role of upper airway stimulation (UAS) therapy in the management of moderate to severe obstructive sleep apnea (OSA). DATA SOURCES: A literature search was performed of PubMed and Medline using the search terms clinical trial; obstructive sleep apnea; upper airway stimulation; hypoglossal stimulation; hypoglossal nerve; Inspire; and ImThera. REVIEW METHODS: All published clinical trials of currently available devices were reviewed...
September 2016: Laryngoscope
Clemens Heiser, Erica Thaler, Maurits Boon, Ryan J Soose, B Tucker Woodson
Selective upper airway stimulation has been established as an additional treatment for obstructive sleep apnea (OSA). Essential for the treatment is the precise placement of the cuff electrode for select branches of the hypoglossal nerve, which innervate the protrusors and stiffeners of the tongue. A direct approach to the distal hypoglossal nerve has been established to achieve this goal. For surgeons, detailed knowledge of this anatomy is vital. Another decisive step is the placement of the sensing lead between the intercostal muscles...
September 2016: Laryngoscope
Demet Altun, Emre Çamci
We report a case of anesthetic management of a 43-year-old patient with Eagle's syndrome (ES) in whom post-extubation acute airway obstruction occurred due to bilateral hypoglossal nerve paralysis. After an accurate examination, elongated bilateral stylohyoid ligament was observed and surgical resection was planned. After completion of the surgery following extubation, significant dysfunction in swallowing, speech function, and tongue motion was observed. The clinical situation was evaluated as bilateral hypoglossal nerve paralysis related to the procedure...
August 20, 2016: Journal of Anesthesia
S M Weindling, R D Goff, C P Wood, D R DeLone, J M Hoxworth
Isolated hypoglossal nerve palsy is uncommon, and underlying craniocervical junction degenerative disease has rarely been reported as an underlying cause. To improve understanding of this entity, we present a retrospective series of 18 patients with hypoglossal palsy in whom twelfth cranial nerve compression within the premedullary cistern or hypoglossal canal, or both, was found secondary to craniocervical junction juxta-articular cysts, retro-odontoid fibrous pseudotumors, and osteophytes. The imaging techniques and characteristic craniocervical junction degenerative disease lesion imaging findings presented here might help clinicians interpreting hypoglossal palsy imaging studies avoid perceptual and interpretive errors commonly found in the present series...
August 18, 2016: AJNR. American Journal of Neuroradiology
Marcel Kullmann, Marcos Tatagiba, Marina Liebsch, Guenther C Feigl
OBJECTIVE: Investigation of the predictive value of changes in intraoperatively acquired motor evoked potentials (MEPs) of the lower cranial nerves CN.IX-X (glossopharyngeal-vagus nerve) and CN.XII (hypoglossal nerve) for the operative outcome. METHODS: MEPs of CN.IX-X and CN.XII were recorded intraoperatively in 63 patients undergoing surgery of the posterior cranial fossa. We correlated the changes of the MEPs with postoperative nerve function. RESULTS: For CN...
July 30, 2016: World Neurosurgery
Eric J Kezirian
Hypoglossal nerve stimulation with an activated implanted device does not awaken individuals from sleep once they have acclimated to the new sensation of the resulting tongue movement. This case report illustrates the importance of an acclimation period, allowing a patient to become accustomed to stimulation settings below the level at which there is gross tongue movement. Laryngoscope, 126:S20-S21, 2016.
September 2016: Laryngoscope
Saeed A Alqahtani, Caroline Agha, Ted Rothstein
BACKGROUND Isolated unilateral hypoglossal nerve injury is extremely rare. It may be caused by radiation therapy targeting neoplasms of the cephalic region. CASE REPORT A 51-year-old man with synovial sarcoma of the left upper arm status post extensive radiation therapy in 1980 presented in late 2014 with gradual onset of speech difficulty and difficulty moving his tongue for a couple of weeks. Neurological examination revealed isolated left-sided unilateral tongue atrophy. Postradiation residual extensive cicatrix with erythema over the whole left upper extremity extending to the neck on the affected side was noticed...
2016: American Journal of Case Reports
Yong Li, Jinrong Lou, Shujun Qiu, Yutian Guo, Mianshun Pan
Cases of hypoglossal schwannoma are extremely rare. Historically, microsurgical resection has been the standard treatment, but it may not always be feasible; thus, it is crucial to investigate alternative treatments. We herein present the cases of two patients, both of whom presented with tongue deviation and hemiatrophy, accompanied by headaches. Magnetic resonance imaging revealed a dumbbell-shaped tumor originating from the hypoglossal nerve that was adjacent to the cranial base in each patient. Hypofractionated stereotactic radiotherapy was used to treat the tumors, with a total dose of 30 Gy in 3-Gy fractions delivered to the planning target volume...
August 2016: Molecular and Clinical Oncology
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